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68wm6 p2 Com Neu Dis
Common Neurological Disorders
| Question | Answer |
|---|---|
| What is Cephalalgia? | Headache |
| What are the contributing factors to migrains? | *Emotional stress *Excess carbohydrates *Iodine rich foods *Alcohol *Chemical additives *Fatigue |
| What are episodic headaches lasting 30 minutes to 2 hours occuring in groups? | Cluster headaches |
| How often do cluster headaches occur? | Occur over a 6 to 8 weeks period after onset with 2 to 10 headaches per day on one side of the head |
| How much time elapses between onset and reaching maximum pain in PTs with cluster headaches? | "Very little time between onset and maximum pain" |
| What are the most common headaches? | Tension (90% of all headaches) |
| Rapid reduction of intracranial pressure by lumbar puncture may result in what? | Herniation |
| When is a lumbar puncture done in diagnosis of cause of extreme headaches? | In the absence of a brain tumor or increased ICP (CT scan must be done 1st) |
| Why should ETOH (alchohol) be avoided in people with chronic headaches? | it may become addictive and can trigger cluster headaches |
| List 4 comfort measures that can be provided for headache relief: | *Cold/warm packs *Pressure applied to the temporal arteries *Stimuli reduction *Provide for rest and relaxation *Encourage regular physical exercise *Cluster care to allow adequate rest periods |
| What medication is given in Tx of vascular headaches for vascular control? | Ergot derivatives (dihyroergotamine and ergotamine) |
| What is the action of Ergot derivatives (dihyroergotamine and ergotamine)? | directly stimulate alpha-adrenergic and serotonin receptor, producing vascular smooth muscle vasoconstriction |
| What are Ergot derivatives (dihyroergotamine and ergotamine) commonly given in combination with? | Caffeine, phenobarbital and belladonna |
| Why are vascular headache suppressants contraindicated in pregnant women? | causes contractions of the uterine smooth muscle |
| What migrain medication should NOT be used in conjunction with ergot derivitaves? | Zolmitriptan (Zomig) |
| What drug types are given in Tx of migraines? | *Serotonin receptor agonists ('Triptans') *Beta-Blockers ('Olols') *Opiates/derivitives |
| When is medication for migraines administered? | At first sign of headache, and only during headache |
| What is neurological pain? | Transmission of pain impulses due to a disorder within the nervous system |
| What is Transcutaneous electrical nerve stimulation (TENS)? | Tx in which electrodes are used to modify sensory input and change pain sensation in PTs with neurological pain |
| What is spinal cord stimulation (TENS)? | Tx in which electrodes are used to modify sensory input and change pain sensation in PTs with neurological pain |
| How long can the effects of a nerve block last? | months to years |
| What is a neurectomy? | nerve excision |
| What is a Rhizotomy? | Cut of a spinal nerve root |
| What is a Cordotomy? | Cutting a nerve in the spinal cord |
| What is a Percutaneous Cordotomy? | Destruction of a nerve bundle by means of an electric current |
| What is the MOST important nursing intervention for PTs with neurological pain? | Patient Teaching |
| What life sustaining mechanisms become impaired in PTs with ICP? | *Decreased LOC *BP (systolic increase as body attempts to increase profusion to brain—eventually ends in hypotension) *HR - Bradycardia *Temperature regulation |
| What is the early sign of increasing ICP? | LOC |
| What are the pupillary changes in a PT with ICP? | *Size changes occur on same side as lesion *Progresses from constriction to dilation |
| What causes the pupillary changes from ICP? | *Results from loss of parasympathetic input from the CN III *Terminal stage is dilated, fixed pupils due to compression of CN III |
| What is cushings syndrome? | A widened pulse pressure (120/60 -> 160/60), increased systolic BP and bradycardia |
| What regulates the temperature in the brain, and when it is in dysfunction due to ICP what happens to the PTs temperature? | Hypothalamus, Increases |
| When is papilledema a first sign of ICP? | If ICP elevated gradually |
| Who generally first finds papilledema? | Physician upon exam |
| In a PT with ICP, where is the ventricular catheter placed? | Placed on non-dominant side, anterior horn of lateral ventricle (allows for drainage of CSF to decompress brain) |
| What are the injuries secondary to ICP? | neuronal ischemia and/or hypoxia |
| What is the hyperosmotic agent used in Tx of ICP? | IV Mannitol |
| When does the effect of mannitol begin and how long does it last? | 15 minutes, 5-6 hours |
| What is a craniotomy? | bone flap removed and replaced |
| What is a craniectomy? | bone flap removed and not replaced (often used in trauma to allow brain to swell out of hole) |
| How must the bed of a PT with/recovering from ICP be placed? | HOB elevated 30-45 degrees |
| The PT with ICP shows polyuria. What condition that can be caused by cerebral edema from ICP would you suspect? | Diabetes Insipidus |
| What is an Electromyogram? | Applying surface electrodes or inserting needle electrodes into a muscle to observe electrical activity |
| How often should active/passive ROM excersizes be performed on a PT with motor function disturbances? | At least 3 times a day |
| What is Proprioception? | Ability to know the body position without looking directly at it |
| Foods containing what may instigate migraines? | *Tyramine *Nitrates *Glutamates (I.e MSG) |
| What foods may instigate migraines? | *Vinegar *Chocolate *Cheese *Yogurt *Alchohol *Caffeine |
Created by:
Shanejqb
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